CLIENTS

Clientele

Dr. Piatigorsky serves high-performance athletes across club, collegiate, professional, Olympic, and national team levels. He also supports elite athletes in adventure sports.

Services are available to adults aged 18 and older, delivered with cultural competence and respect for differences in race, ethnicity, culture, nationality, identity, sexual orientation, religion, and other diversity factors.

Athletic Disciplines

Dialectical Sports Skills (DSS) extend universally across virtually every individual, team, and niche sport. In partnership with each client, Dr. Piatigorsky adapts these skills to the client’s specific sport, shaped by their knowledge, experience, and goals.

Clients represent many disciplines, including:

  • Aquatics: diving, swimming, rowing, sailing, surfing, water polo

  • Adventure: kayaking, mountain biking, mountaineering, rock climbing

  • Endurance: cycling, running, triathlon

  • Solo: gymnastics, golf, tennis, table tennis, track & field

  • Winter: Nordic and alpine skiing, snowboarding

  • Team: baseball, basketball, field hockey, football, lacrosse, rugby, soccer, volleyball

Presenting Problems

Clients present with a range of problems that vary by overall severity, life impact, and required support. Problems may be mental health–related, performance-related, or both. They may be isolated and circumscribed, or longstanding and more complex. The following are common presenting problems:

CLINICAL

Affect & Mood
• Anger • Anhedonia • Depression • Euphoria • Guilt • Hopelessness • Irritability • Lability • Regulation • Shame

Anxiety
• Avoidance • Generalized • Panic • Phobia • Social • Restlessness • Worry

Behavior
• Aggression • Antisocial • Hyperactivity • Impulsivity • Procrastination • Rigidity

Cognitive
• Confusion • Disorganization • Distortions • Inattention • Indecision • Judgment • Memory • Psychosis • Rumination • Thinking Errors

Compulsive
• Checking • Eating • Gambling • Hoarding • Obsessions • Rituals • Rumination • Sexuality • Substance Use

Contextual
• Academic • Existential • Family • Financial • Interpersonal • Isolation • Occupational • Peers

Personality
• Abandonment Fears • Detachment • Egocentrism • Emptiness • Entitlement • Grandiosity • Perfectionism • Suspiciousness

Physical Health
• Concussion • Illness • Nutrition • Pain • Rehabilitation • Sleep • Underweight • Weight Change

Somatic
• Appetite • Fatigue • Headache • Insomnia • Nausea • Palpitations • Restlessness • Tension • Trembling

PERFORMANCE

Behavior
• Accountability • Choking • Competence • Reactivity • Self-Monitoring • Self-Soothing • Stimulus Management

Cognitive
• Adaptability • Decisiveness • Egos • Imagery • Mindset • Overthinking • Perfectionism • Self-Talk

Consistency
• Execution • Follow-Through • Persistence • Preparation • Reliability • Reset • Routine

Focus
• Attention • Awareness • Concentration • Cueing • Flow • Jitters • Refocus

Motivation
• Autonomy • Confidence • Connection • Discipline • Goals • Resilience • Rewards

Personal
• Academics • Career • Identity • Injury • Job Insecurity • Lifestyle • Retirement • Transition • Wellness

Physiology
• Arousal • Endurance • Energy • Fatigue • Fueling • Hydration • Pacing • Recovery • Yips

Systems
• Boundaries • Feedback • Hierarchies • Logistics • Medicine • Physical Therapy • Training Load

Team
• Coaching • Cohesion • Communication • Conflict • Cooperation • Leadership • Roles • Social Comparisons • Trust

Training
• Cross-Training • Peaking • Periodization • Risk Management • Tapering